A STUDY OF HEARING IMPROVEMENT AFTER ADENOIDECTOMY VS. ADENOIDECTOMY WITH GROMMET INSERTION IN THE CASE OF OTITIS MEDIA WITH EFFUSION

Main Article Content

Dr. Nilamadhaba Prusty
Dr. Dillip Kumar Pradhan
Dr. Biswaranjan Prusty
Dr. Siddharth Panditray

Keywords

Otitis Media with Effusion, Adenoidectomy, Grommet Insertion

Abstract

Background: Otitis Media with Effusion (OME), also known as Secretory Otitis Media, has been identified as the commonest middle ear condition causing deafness in children in developed countries. Otitis media with effusion is one of the most common chronic otological conditions and the most common cause of conductive hearing loss in the pediatric population. Ventilation tube insertion with or without adenoidectomy is considered a standard surgical procedure.


Aims and Objectives: The hearing improvement after adenoidectomy vs. adenoidectomy with grommet insertion in the case of otitis media with effusion.


 Materials and Methods This study was conducted in the Department of ENT in different private clinics in Balasore and Cuttack, Odisha. It consists of 60 patients, and their ages range from 2 to 12 years.


Result: In our study, the predominant age group was between 2–5 years (31.67%) and 8–11 years (31.67%). The mean age was 6.96. Higher incidence in male (71.67%) than female (28.33%) children. Preoperatively, 63% of ears had a dull tympanic membrane, and 37% of ears had an amber-colored tympanic membrane. All the patients had a B-type tympanogram curve. Postoperatively, at the end of 6 months of follow-up, patients who underwent adenoidectomy with grommet insertion had 94% normal tympanic membrane, 92% had a type A tymanogram curve, a mean PTA of 8.47 with a P value of <0.001, and 84% had an AB gap < 10 dB. While patients who underwent adenoidectomy alone had a 72% normal tympanic membrane, 64% had a type A tympanogram curve with a mean PTA of 15.40 dB with a P value of <0.001 and an AB gap of <10 dB in 60% of children. In Group A, 11 patients had persistant retracted tympanic membrane at the end of 6 months of followup, and hence these patients were taken up for myringotomy with grommet insertion, and they all improved symptomatically.


Conclusion: It is evident that secretory otitis media is a treatable cause of conductive hearing loss, and it is due to Eustachian tubal dysfunction secondary to adenoid hypertrophy and recurrent upper respiratory tract infection.


 

Abstract 174 | PDF Downloads 52

References

1. Shaheen MM, Raguib A, Shaikh MA. Chronic suppurative otitis media and secretory otitis media and its association with socio-econonic factors among rural primary school children of Bangladesh. Indian J Otolaryngol Head Neck Surg. 2012;64:36- 41
2. Sigdel B, Nepali R. Pattern of ear diseases among pediatric ENT patients: An experience from the tertiary care centre,Pokhara, Nepal. Journal Nepal Paediatric Society 2012; 32:142-5.
3. Bluestone CD, Beery QC, Andrus WS. Mechanics of the eustachian tube as it influences susceptibility to and persistence of middle ear effusions in children. Ann Otol Rhinol Laryngol. 1974; 83(Suppl 11):27-34.
4. Crapko M, Kerschner JE, Syring M, Johnston N. Role of extra-esophageal reflux in chronic otitis media with effusion. Laryngoscope 2007; 20:74-78
5. Parma S, Gohil CS, Patel V, Patel A. Comparative Study Of Secretory Otitis Media And Chronic Suppurative Otitis Media in School Going Children Aged Between 5 To 12 Years In Local Municipal School. Int J Med Surg Emerg. 2013; 1(3):53-5.
6. Roberts JE, Burchinal MR, Zersel SA. Otitis Media in Early childhood in relation to children’s school age language and academic skills. Pediatrics 2002; 110:696-706 .
7. Chang CW, Yang YW, Fu CY, Shiao AS. Differences between children and adults with otitis media with effusion treated with CO2 laser myringotomy. J Chin Med Assoc. 2012; 75:29–35.
8. Zielhuis GA, Rach GH, Van den Basch A, Van den Broek P.The prevalence of otitis media with effusion : a critical review of the Literature. Clinical Otolaryngology. 1990; 15:283-8.
9. Prevalence and risk factors of otitis media with effusion in school children in Eastern Anatolia. Kırıs M1 , Muderris T, Kara T, Bercin S, Cankaya H, Sevil E. Int J Pediatr Otorhinolaryngol. 2012 Jul;76(7):1030-5.
10. Engel J, Anteunis L, Volovics A, Hendriks J, Marres E. Risk factors of otitis media with effusion during infancy. International Journal of Paediatric Otolaryngology.1999b; 48: 239-49.
11. Tos M, Holm-Jensen S, Sorensen CH, Mogensen C.Spontaneous course and frequency of secretory otitis in 4-year-old children. Archives of Otolaryngology.1982; 108: 4-10.
12. Otitis media with effusion: Accuracy of tympanometry in detecting fluid in the middle ears of children at myringotomies Khurshid Anwar, 2016 Mar-Apr; 32(2): 466–470.
13. A systematic review of adenoidectomy in the treatment of otitis media with effusion in children; Tian X, Liu Y, Wang M, Liu H; 2014 Apr;29(8):723-5.
14. A randomized control trial of surgery for glue ear N A Black, C F B Sanderson, A P Freeland, M P Vessey ; Br Med J 1990;300:1551-6.

Most read articles by the same author(s)